Vermont Works for Women · Vermont Works for Women Donation Form

Name

*

First Name

Last Name

Additional Donor Name

First Name

Last Name

Email

*

Sign me up for Vermont Works for Women's e-newsletter

Address

*

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Donation Amount

*

$50

$100

$250

$

Donation Schedule

Send my acknowledgement letter:

*

via e-mail

via snail mail

Gift Recognition

Please recognize my gift as from:

e.g. 'Jane Doe' or 'Jane and John Doe' or 'The Doe Family' or 'Company Name'

Is this a tribute gift?

If yes, you'll be able to specify the honoree in the next step.

No

Yes, an honorary gift

Yes, a memorial gift

Please provide the name and contact information of the honoree

Provide a mailing address or an email address if it's ok for us to let them know about your gift.

Name of the deceased

Please provide contact information for a friend or relative

Any other instructions?